Political Cortex: Brain Food for the Body Politic

I've been researching and writing on combat-related PTSD incidents since September. A collection of fact-checked and confirmed incidents resulting in violence or death due to PTSD now number over 60, and are found at ePluribus Media's PTSD Timeline. These, of course, only give a small glimpse into a massive problem as most cases are not reported on and remain extremely private.

Though hidden from view, the problems remain.

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A Look At Some PTSD Stats

The PTSD-related wounds of the combat veteran are deadly serious. If left untreated, under-treated, or if not taken seriously by those involved in PTSD treatment, possible outcomes that may result include:

• suicide
  
  
• accidents
  
  
• violence towards family members or strangers
  
  
• irrational and impulsive choices putting them/others in danger
  
  
• an increased risk of death from cardiovascular diseases
  
  
• an increased risk of death from cancer

The following culled from Hidden Combat Wounds: Extensive, Deadly, Costly

Roughly 6-7% of soldiers evacuated from OEF and OIF combat zones suffered from psychiatric problems.

Iraq Evacuation Totals, Mar-19-03 thru Jul-31-05:

596 for depression + 109 for suicidal ideation + 91 for PTSD = 1,275

Suicide Data Review, 2003 to July 19, 2005

53 in Iraq

 9 in Afghanistan

Yet, most PTSD-related suicides occur once the soldier has saftely returned home.

Additional data points:

• 19% to 21% of returned combat vets suffer from PTSD, depression or anxiety.

• 15% to 17% of Iraq, and 6% of Afghanistan vets had PTSD symptoms 3 to 12 months after their deployments.

• PTSD rates were highest for combat deployments of 12 months or more.

• A survey of 1,300 paratroopers three months after they had returned to Fort Bragg, N.C., after spending a year in Iraq, found that 17.4% of the soldiers had PTSD symptoms.

• Comparing the mental health of men and women in violence-prone jobs (e.g., medics, mechanics, drivers) in Iraq, 11% of the men and 12% of the women had PTSD symptoms 3 months after their deployment ended.

• Of the 138,000 troops who returned in 2004 and received a post-deployment health assessment, 16% have been referred to mental health providers for further evaluation

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What's the DoD Have to Do With It?

The U.S. Department of Defense (DoD) is currently using the following means to diagnose and treat the mental health of our troops:

• Annual service personnel mental health screening during a preventive health assessment.
  
  
• Another screening prior to deployment.
  
  
• Unremitting mental health disorder patients are not deployed.
  
  
• If a mental health condition has resolved, troop permitted to stay on maintenance medication during deployment.
  
  
• Embedded mental health teams with deployed military units.
  
  
• Military OneSource for military members and families -- a confidential, around-the-clock information, education, referral and counseling service.
  
  
• Completion of a 4-page post-deployment health assessment as they are leaving the combat zone or within a few days of returning home.
  
  
• Face-to-face discussion with a military medical provider
  
  
• Individuals with mental health referrals may have base counselors and chaplains available to them.
  
  
• They can also go to military primary care facilities.
  
  
• Or they could go to a mental health clinic, where they would see a psychologist or psychiatrist.
  
  
• A new, short interview questionnaire (Post-Deployment Health Reassessment [PDHRA]) to be filled out by all service members, including those serving in the Reserves or National Guard, 3 to 6 months after returning home.

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Early Intervention is Key

Vietnam taught us the importance of providing early treatment to PTSD-wounded veterans.

Studies of Vietnam War veterans underscore the importance of early treatment of PTSD symptoms to prevent emergence of other psychiatric and medical disorders. One recent study concluded that Vietnam War veterans with PTSD may be at increased risk of death (Boscarino, 2005).

The national study examined the causes of death among 15,288 male U.S. Army veterans 16 years after they had completed a telephone health survey, which included questions related to PTSD symptoms and substance abuse, and 30 years after their military service. The study confirmed that PTSD was associated with an adjusted all-cause mortality for both Vietnam War era and theater veterans. For PTSD-positive theater vets, the postwar mortality for all-cause, cardiovascular, cancer and external causes (e.g., deaths from suicides, homicides, accidents) was about twice as high as that of Vietnam War veterans without PTSD.

If we can reduce the anxiety level in our returning troops, now, they will have a healthier, longer life in the years to come. Costs for their treatment will also be reduced, easing the financial burdens on federal budgets in disarray.

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The VA: Caught Off-Guard?

In 2004, the VA saw 279,000 patients at VA health care facilities for PTSD and 63,000 in Vet Centers:

In September 2004, the U.S. Government Accountability Office (GAO) raised questions as to whether the VA could meet an increase in demand for PTSD services at its facilities, emphasizing, "The VA does not have a count of the total number of veterans currently receiving PTSD services at its medical facilities and Vet Centers." It also pointed out that at six VA facilities investigators visited, the staff said they were able to keep up with current number of veterans seeking PTSD services, but might not be able to meet an increase in demand.

That was in 2004. Last year, you might remember the big uproar following the VA's announcement that its Inspector General was gearing up to audit 72,000 PTSD cases; following a large uproar, by November of 2005 those plans were dropped.

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What You Can Do

Representative Lane Evans and Senator John Kerry have introduced legislation favorable (yet slow-moving) to help with PTSD and veterans' healthcare in general. Please consider contacting their offices (click on their names) and thank them. And consider asking your own district/state leaders to support their work.

Thank you!